The effect of 7 years of intense exercise training on patients with coronary artery disease

The purpose of this study was to evaluate the effects of long-term exercise training on maximal aerobic exercise capacity, evidence of myocardial ischemia and plasma lipid-lipoprotein concentrations in patients with coronary artery disease. Nine men with coronary artery disease, aged 57 ± 2 years, who had completed 12 months of supervised intense exercise training were restudied after 6 additional years during which they continued to exercise. The first 12 months of training resulted in a 44% increase in maximal oxygen consumption ( VO₂max) from 25.0 ± 1.3 to 35.9 ± 1.5 ml kg⁻¹ min⁻¹ (p < 0.001). The VO₂max after 6 additional years (total 7 years) of intense training was 36.8 ± 2.4ml·kg⁻¹min⁻¹. Plasma high density lipoprotein (HDL)-cholesterol concentration increased from 38 ± 3 to 45 ± 4 mg dl⁻¹ at 12 months and rose further to 53 ± 5 mg.dl⁻¹ at 6 years of follow-up (p < 0.05). The atherogenic index (total cholesterol/HDL-cholesterol ratio) decreased from 5.8 ± 0.4 to 4.9 ± 0.4 by 12 months (p < 0.01) and to 4.1 ± 0.4 after 6 additional years of training (p < 0.05). Although the maximal heart rate-pressure product was 14% higher after 12 months of training, maximal ST segment depression was significantly less, 0.27 ± 0.06 versus 0.19 ± 0.04 mV (p < 0.05); this improvement was maintained after 6 years of additional training. These data provide evidence that the beneficial effects of a program of intense exercise training can be maintained for long periods in some motivated patients with coronary artery disease who continue to exercise.